Thursday, February 16, 2023

An inside look at S2C: “We actually discourage them from using their speech while they are spelling”

(Cross-posted at FacilitatedCommunication.org).

I recently came across a curious blog post at Age of Autism. Dating back to 2021, it offers an inside look at Spelling to Communicate (S2C) and at some of its practitioners.

The post’s author, Dara Berger, is the mother of an autistic boy, the author of Preventing Autism, a believer in the (debunked) vaccine injury theory of autism, and an ally of the S2C and vaccine-injury-evangelist, J.B. Handley, whose book, Underestimated: An Autism Miracle, is the basis for the forthcoming S2C-promoting movie Spellers.

As Berger states towards the end of her post:

My experience is not meant to dissuade anyone from doing S2C.  I am elated for all the children and adults it has helped and will continue to.  There is nothing sweeter than to hear a person who previously could not communicate has now found a way to get their voice heard.  I encourage everyone to look into it and read JB Handley’s book.

But Berger’s own experience with S2C was not so positive.

Her autistic son, a homeschooled sophomore, is able to speak. He also “has great print and cursive penmanship.” His linguistic limitations are, rather, in his ability to initiate conversations.

My son already spoke but there was no initiation of language.  This means he can answer questions all day long but will not initiate language on his own.

Given her son’s oral and written strengths, why did Berger turn to S2C? Indeed, some of the commenters on her post raise precisely this question.

The answer is that Berger thought that S2C would address her son’s weakness in verbal initiation. And while she does not explain where this impression came from, a quick look S2C’s main website, Growing Kids Therapy Center, (GKTC) is suggestive.

The clients that GKTC advertises itself as serving include those who are “minimally speaking.” A minimally speaking person, per GKTC, is one who “may be able to use some speech to produce a number of words or phrases but does not have enough speech for robust and flexible communication.” As GKTC’s FAQ page elaborates, “minimal speech is often used for requesting wants and needs or providing short answers to questions.”

Given this, we can understand why Berger might reasonably have concluded (1) that her son, who, again, “can answer questions all day long but will not initiate language on his own,” qualifies as minimally speaking; (2) that S2C’s goals include developing the “robust and flexible communication” that minimal speakers lack; and (3) that “robust and flexible communication” includes initiating conversations.

In other words, if we set aside these two inconvenient facts:

  • S2C lacks empirical validity

  • All the available evidence indicates that the communication partners are authoring the typed messages

Berger had good reasons for thinking that S2C would address her son’s needs.

But despite her continued faith in the overall validity of S2C, Berger was dismayed at what she personally experienced.

The first red flag occurred after several months of mostly remote sessions with an S2C practitioner from GKTC:

[M]y son was using a lot more speech in his lessons.  He would answer the questions verbally instead of using the letter board.  Now you can imagine just how excited this made me.  Things were finally paying off I thought. 

To Berger’s surprise, however,

[H]is S2C practitioner did not share the same enthusiasm as me.  In fact, she blew it off and ignored the fact that he was doing this.  Not only that, she pretty much discouraged his speech by ignoring that he said the answer and told me to have him spell it anyway. 

Berger called off the session and expressed her concerns to the S2C practitioner, “Kara” (a pseudonym). Kara, she reports, “kept saying that he just needed to get better at the letter board,” while she “kept insisting this is every parents [sic] dream to hear them answer questions verbally on their own.”

So Berger consulted her son’s SLP. In practice for over 40 years, “Andrew” is “very familiar with letter boarding and one of those very special therapists who actually presumes competence.” Furthermore, Andrew had “recently seen a few young adults go on to college successfully using a keyboard.” Nonetheless, after some careful consideration, Andrew “could not hold back.” He stated that the S2C practitioner was “wrong”; that in cases where her son gave an oral response, “he should not be made to spell it like he did something wrong”. Her son’s oral responses “need[] to be accepted period.”

But when Berger brought this up with Kara, “she blew me off and said this is how we do it and he needs to get better at letter boarding.” Worse, during the session, her son stopped giving oral answers. After all, Berger points out, “Why would he when they were not being accepted anyway.”

Meanwhile, another S2C mother tells her about some “great online classes for spellers,” including such courses as Ancient Civilizations and Cultural Literature. Berger, seeing these as great additions to her home schooling curriculum, signed up right away. As she describes them:

These group classes were set up similar to his individual spelling class in that she reads us a paragraph from a lesson and then gives the students a few questions to answer.  The spelling partner types the child’s answer in the chat area. 

However:

[T]o my surprise Dylan preferred to answer verbally [orally] once again and did so for the entire class.  It was interesting that away from Kara this was his immediate reaction to speak.  I listened to his speech therapist and honored every answer and did NOT make him spell it afterwards.  He did the same thing in the next class we took. 

But then when they took a group class taught by Kara, her son reverted back to spelling without speaking.

Once again, Berger brought up her concerns with Kara:

And lo and behold she had the same reaction as the first time.  But I told her that her answer wasn’t good enough and she had to speak with her boss (who developed the technique).

(That boss would be Elizabeth Vosseller, founder of GKTC and “inventor” of S2C.)

Berger excerpts the long reply she received from Kara, highlighting key points about how speech is not the goal of S2C, how speech is unlikely to be her son’s primary mode of communication, and how

when working with a speller, we actually discourage them from using their speech while they are spelling, because focusing on the motor of pointing to letters while trying to speak is too much motor to focus on at once.

Perhaps most notably, Kara’s message notes how Elizabeth Vosseller herself confirms that:

[S]he too, when a speller in the acquisition phase uses their voice to answer a question, has them spell it, just for practice. "Now let's use your arm!”

In the end, Berger turns to other ways to work on verbal initiation:

We do all kinds of creative writing to help put his thoughts on paper.  His OT has him texting and emailing during sessions to use the keyboard, which he types well on. 

As for S2C:

I don’t know if we will continue with S2C.  It’s hard to go work with another practitioner when I know they all receive the same training from the woman who developed it and will be taught the same as Kara.

We’ve already seen troubling instances where a facilitated person’s spoken words are ignored in favor of what is extracted through FC. What stands out in this case is that the FCed individual seems to have had quite a bit more speech than most S2C clients—enough to be able to speak out answers to questions about ancient history and cultural literature. And yet, because the goal was for him to become a fluent letterboard user, and because his S2C practitioner was certain that his speech would never be as good as his typing would eventually become, that speech was dismissed.

We can guess at the real reasons for that dismissal. It is, after all, much harder (if not impossible) to cue the mostly invisible vocal apparatus involved in speech than to cue a single extended index finger hovering over a keyboard.

A couple of the reader comments at the end of this post are suggestive. Two of them stress the purported motor issues and apraxia that purportedly justify S2C , and how S2C helps “myelinate” motor pathways—a claim confidently made, without a shred of evidence, by S2C proponents.

One commenter writes:

Asking your son to spell his answer rather than say it is not a “punishment”; it’s the goal of S2C... It’s practicing the gross motor required for letter boarding. It’s mylenating [sic] those motor pathways.

Another, making the same spelling mistake, writes:

The motor planning ability required to produce robust, purposeful, open-ended speech on demand is really high. In persons with any degree of apraxia or dyspraxia, the demand can be too high or close to impossible. S2C works to create and mylenate [sic] the motor pathways in the brain that are needed to get robust and reliable communication. Reliable communication is the ultimate goal, NOT speech per se. If regular speech therapy worked, these kids with apraxia would be more verbal and more conversational. Unfortunately it doesn’t always work, and much of the time speech is unreliable and/or inaccessible to the child/adult with apraxia. So again, in S2C you are teaching them a new way to communicate.

On a different note, an SLP in New Hampshire writes:

I have one man who will type anything that comes out of his mouth, regardless of context. It results in nonsensical jargon. When I ask him to suppress his speech, his typed words are eloquent. I then ask him to speak what he typed. I accept any reliable speech. I also see a 13 year old girl whose speech is rote and repetitive. When she types, she speaks each letter before she types it, and then repeats the entire sentence.

Of course, the simplest explanation here is that the SLP is unwittingly cueing her clients—and doing so more successfully when they suppress their speech. Notably, these clients are perfectly capable of producing speech sounds--and of reading the names of the appropriate letters—but only after they’ve likely been cued.

Perhaps the most intriguing comment gives an account of how Elizabeth Vosseller stumbled upon S2C. While there are still traces on the Internet of how Vosseller started out as a student of RPM-founder Soma Mukhopadhyay, something she no longer acknowledges, this is the first time I’ve heard an account of the details (assuming they are reliable). This commenter, an RPM-enthusiast who had her first session with Soma in April, 2013, reports that:

Soma asked if we wanted to join 5 other families who would meet with her in our area, once a month for 18 months. We were allowed to bring people to be trained by her to those sessions. Guess who I brought to be trained? EV. I had hired her about 2 months previously to help me create a homeschool program for my son. I asked her to join my Soma sessions so I could begin RPM for my son.

Fast forward and EV has taken what was invented by Soma and renamed it and marketed it S2C. Unfortunately, in the new rebrand of Soma’s method a lot has been compromised. Soma’s lessons are always individualized and have multiple components that support the different sensory channels of each student and are oriented toward the individual motor challenges specific to each person. Her lessons are never one size fits all and she would never just read a paragraph of information and have a student answer questions while someone is holding a board for them. RPM is a complex teaching method that is always evolving and Soma is nothing short of a genius. She does not have the marketing skills, nor business acumen that SC2 has going for it, but believe me, you would not have had an experience like this under her or one of her certified practitioners.

Another commenter corroborates this:

S2c is just a knock off version of RPM, there is a lot more depth to RPM. Soma would never discourage speech and in fact has written a book on working with verbal students because it can be so different from teaching non-verbal students and it is very important to adapt to what the student needs and not be so rigid

And, in fact, several commenters recommend RPM as superior to S2C.

Sadly, of course, it isn’t. As a thorough perusal of our research pages will indicate, the amount of empirical evidence for RPM is no greater than that for S2C, in both cases totaling zero.

No comments: